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High-intensity intermittent exercise increases pulmonary interstitial edema at altitude but not at simulated altitude

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Edsell, Mark, Wimalasena, Yashvi, Malein, William L., Ashdown, Kimberly, Gallagher, Christopher, Imray, C. (Chris), Wright, Alex D. and Myers, Stephen D. (2014) High-intensity intermittent exercise increases pulmonary interstitial edema at altitude but not at simulated altitude. Wilderness & Environmental Medicine, 25 (4). pp. 409-415. doi:10.1016/j.wem.2014.06.016

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Official URL: http://dx.doi.org/10.1016/j.wem.2014.06.016

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Abstract

OBJECTIVE:
Ascent to high altitude leads to a reduction in ambient pressure and a subsequent fall in available oxygen. The resulting hypoxia can lead to elevated pulmonary artery (PA) pressure, capillary stress, and an increase in interstitial fluid. This fluid can be assessed on lung ultrasound (LUS) by the presence of B-lines. We undertook a chamber and field study to assess the impact of high-intensity exercise in hypoxia on the development of pulmonary interstitial edema in healthy lowlanders.

METHODS:
Thirteen volunteers completed a high-intensity intermittent exercise (HIIE) test at sea level, in acute normobaric hypoxia (12% O2, approximately 4090 m equivalent altitude), and in hypobaric hypoxia during a field study at 4090 m after 6 days of acclimatization. Pulmonary interstitial edema was assessed by the evaluation of LUS B-lines.

RESULTS:
After HIIE, no increase in B-lines was seen in normoxia, and a small increase was seen in acute normobaric hypoxia (2 ± 2; P < .05). During the field study at 4090 m, 12 participants (92%) demonstrated 7 ± 4 B-lines at rest, which increased to 17 ± 5 immediately after the exercise test (P < .001). An increase was evident in all participants. There was a reciprocal fall in peripheral arterial oxygen saturations (Spo2) after exercise from 88% ± 4% to 80% ± 8% (P < .01). B-lines and Spo2 in all participants returned to baseline levels within 4 hours.

CONCLUSIONS:
HIIE led to an increase in B-lines at altitude after subacute exposure but not during acute exposure at equivalent simulated altitude. This may indicate pulmonary interstitial edema.

Item Type: Journal Article
Divisions: Faculty of Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine
Faculty of Medicine > Warwick Medical School
Journal or Publication Title: Wilderness & Environmental Medicine
Publisher: Elsevier Inc.
ISSN: 1080-6032
Official Date: December 2014
Dates:
DateEvent
December 2014Published
7 November 2014Available
Volume: 25
Number: 4
Page Range: pp. 409-415
DOI: 10.1016/j.wem.2014.06.016
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access

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